Basic Information
| Provider Information | |||||||||
| NPI: | 1982262648 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | HIROSHI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 375 DIXMYTH AVENUE DEPT OF | ||||||||
| Address2: | INTERNAL MEDICINE RESIDENCY | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087827027 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 375 DIXMYTH AVENUE DEPT OF | ||||||||
| Address2: | INTERNAL MEDICINE RESIDENCY | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087827027 | ||||||||
| FaxNumber: | 5132215865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2019 | ||||||||
| LastUpdateDate: | 05/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | APP-000246521 | OH | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
ID Information
| ID | Type | State | Issuer | Description | 390200000 | 05 | OH | MEDICAID |